MDICINE ANDED IN CANCER

Session on molecular oncology and its use in genetic and biological therapies is a topic of great interest
at cancer erences. Comparativeing, sessions on radiation, chemotherapy, and surgery are quieter,
however molecular technology has occasionally been included to try to enhance traditional therapy. For
the next few years, cancer management outside the context of a clinical trial will continq to be based
almost entirely on surgery, radiation therapy, and systemic treatment with chemotherapy or
hormones[1].

Surgery and radiotherapy

The majority of cancer-related deaths are caused by metastases, mainly as a result of the primary tumor
being successfully controlled locally by surgery and radiation therapy. Advances in surgery and
radiotherapy have the potential to improve survival for patients with these cancers. For the
treatment of the majority of individuals with breast cancer, several sizable randomized trials have
shown that lumpectomy plus radiation therapy and mastectomy are equivalent. The head and neck
malignancies that were treated with concurrent radiation and chemotherapy showed some evidence
of improved local control when local treatment was combined with chemotherapy. [2,3,4]

Chemotherapy
In cancer treatment, a wide races with different structures and modes of action are employed, such as
natural products, hormones and hormone antagonists[8,9], alkylating agents, antimetabolite analogs,
and other treatments that target certain molecules.[5,6,7]

PROBLEMS IN CONVENTIONAL MEDICINE-

1. Low therapeutic index; [10]
2. Drug resistance:[11]
3. Drug penetration through tissue limits effectiveness of chemotherapy[12]
4. High-dose chemotherapy:[13]

Reference-

1. Conventional cancer therapy: promise broken or promise delayed? - The Lancet.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(98)90327-0/fulltext.

2. Treatment of cancer with radiation and drugs.

J Clin Oncol. 1996; 14: 3156-3174

3. An overview of randomised controlled trials of adjuvant chemotherapy in head and neck cancer.
Br J Cancer. 1995; 71: 83-91

4. Adjuvant and adjunctive chemotherapy in the management of squamous cell carcinoma of the head
and neck region: a meta-analysis of prospective and randomized trials.

J Clin Oncol. 1996; 14: 838-847

5. Gilman A & Phillips FS. The Biological Actions and Therapeutic Applications of the B-Chloroethyl Amines and
Sulfides. Science 1946;103(2675): 409-436.
6.Wasserman TH, Slavik M, Carter SK. Clinical comparison of the nitrosoureas. Cancer 1975;36: 1258-
1268
7. Farber S, Diamond LK. Temporary remissions in acute leukemia in children produced by folic acid antagonist, 4-
aminopteroyl-glutamic acid. New England Journal of Medicine. 1948; 238(23):787-793
8. Brunton LL, Chabner BA & Knollmann BC. Goodman & Gilman’s. The Pharmacological Basis of Terapeutics. New York:
McGraw-Hill Companies 2011.
9. Schlossmacher G, Stevens A & White A. Glucocorticoid receptor-mediated apoptosis: mechanisms of resistance in cancer cells.
Journal of Endocrinology 2011;211: 17-25.
10. Protein farnesyltransferase inhibitors block the growth of ras-dependent tumors in nude mice.
in: 3rd ed. Proc Natl Acad Sci USA. 91. 1994: 9141-9145
11. Drug resistance and experimental chemotherapy.

in: Tannock IF Hill RP The basic science of oncology. 3rd ed. McGraw-Hill, New York1998: 392-419

12. 1995 Whitaker lecture: delivery of molecules, particles and cells to solid tumors.

Ann Biomed Eng. 1996; 24: 457-473

13. Clinical impact of chemotherapy dose escalation in patients with hematologic malignancies and solid
tumors.

J Clin Oncol. 1997; 15: 2981-2995